Vaccination & TB Skin Test - College of Southern Nevada

CSN Infection Control Manager – 651-5595
12.2011
Vaccination & TB Skin Test
TIPS
*** PROGRAM REQUIREMENTS VARY***
Consult with program directors and advisors for specific program requirements
and requirement deadlines.
IT IS THE STUDENT’S RESPONSIBILITY TO KNOW WHAT IS REQUIRED FOR HIS/HER
SPECIFIC PROGRAM OF STUDY
Vaccine Doses Administration Schedule
Hepatitis A
2 Minimum 6 months apart
(Childcare & Culinary)
Hepatitis B 3
1, 2
0, 28 days, 4-6 months
MMR 2 Minimum 28 days apart 1
Rabies
(Veterinary Tech)
Tdap (tetanus,
diphtheria, pertussis)
Varicella (chicken
pox)
3 #1 administered on day 1, #2 administered on day 7, #3 administered on day 21 or
day 28.
1 Every 10 years
2 Minimum 28 days apart 1
1
Second dose of varicella, MMR, hepatitis B vaccine CANNOT be given sooner than 28 days after first dose.
2
Third dose of hepatitis B vaccine MUST be given at least 8 weeks after second dose and 16 weeks after first dose. (#1 and #3
must be separated by a minimum 16 weeks)
3
Tuberculosis skin test (PPD) MUST be evaluated within 48-72 hours after the skin test is administered. If not, the test is
invalid and must be repeated a minimum of 7 days after the initial test and at the student’s expense. The test results must be
evaluated (read) by the same healthcare facility that administered the test.
1) Repeat vaccines: No harm in repeating vaccines. Simply provides strong immunity.
2) Pregnant students: Call CSN Infection Control Manager for details.
3) Sick students: Vaccines can safely be administered during a minor illness unless the student is exhibiting a fever of
100.5 o or above. Recovering from an illness, having a cold or taking antibiotics are not contraindications.
4) Live, inactivated vaccines (MMR, Varicella):
a. CANNOT be given BEFORE TB skin test unless 28 days elapses before administering a TB skin test.
b. Live vaccines CAN be given at the SAME TIME as a TB skin test without interfering with the results.
c. More than one live vaccine can be given at the same time or the same day.
d. Dose 1 and 2 of a live vaccines (MMR, Varicella) must be separated by minimum 28 days.
5) Current TST: No more than 365 days SINCE administration of a TB skin test. For a two step TB skin test, the 365
day time interval starts the day the second test is administered.
6) One Step TST: Administer the test, read results 48-72 hours later. The student must return to the same facility to have
the test evaluated (read) within 48-72 hours of administration of the test.

7) Two Step TST: Administer the test. Read results 48-72 hours later. Minimum 7days after administration of the first
step. Administer step 2. Read results 48-72 hours later.
NOTE: Some healthcare facilities often provide a two step TST as follows. Administer step 1. Seven days later, read
results and administer step 2. Read results 48-72 hours later. This will be accepted by CSN.
8) TST intervals: Steps 1 and 2 must be separated by minimum 7 days between administration dates. The test results must
be evaluated (read) at the healthcare provider facility where the test was administered.
9) Positive TST readings: A TB skin test is considered positive if the resulting diameter of the induration (elevated skin
area, not the area of redness) measures:
a. 10 mm or more for foreign born individuals
b. 15 mm or more for US born individuals
10) Positive TST
See CSN TB Skin Test Policy and/or call CSN Infection Control Manager for details.
a. Written documentation of a positive TB skin test must be provided.
b. NEW positive TB skin test
i. Must be referred to a healthcare provider for an evaluation, chest x-ray (CXR) and/or
treatment/preventive recommendations, if applicable.
ii. Provide the health program with
1. written results of positive TB skin test
2. written CHX report from the radiologist (not the actual x-ray)
3. Completed Tuberculosis Symptom Screening Questionnaire
c. HISTORY positive TST
i. Must provide written documentation of the past positive TB skin test.
1. If documentation of past positive TB skin test student will get one TB skin test to document status.
ii. Must show documentation of clear CXR taken as follow-up to previous positive TB skin test no older
than 2 years
iii. Written documentation of negative CXR indicating no active pulmonary disease
iv. Completed Tuberculosis Symptoms Screening Questionnaire annually.
1. If symptoms suggestive of TB develop an immediate referral to healthcare provider required.*
v. Exempt from further TB skin tests (TB skin test will always result in positive).
12.2011
d. HISTORY positive TB skin test WITH documentation of successfully completing the recommended course
of INH treatment
i. Documentation of successfully completing the recommended course of INH treatment (minimum 6
months)
ii. Complete Tuberculosis Symptom Screening Questionnaire annually.
1. If symptoms suggestive of TB develop an immediate referral to healthcare provider required.*
iii. Exempt from further TST and chest x-rays
* CONFIRMED or SUSPECTED TB INFECTION – CSN Infection Control Manager and Southern Nevada
Health District must be notified immediately.
11) FOREIGN born individuals – Many are given BCG vaccine as a child. BCG interacts with TST resulting in a positive
skin test. This positive TB skin test is often a false positive.
a. Written documentation of a positive TB skin test must be provided.
b. CDC recommends every positive TST be evaluated further with a follow-up chest x-ray (CXR)*, regardless
whether or not there is a history of BCG.
c. Must provide written results of negative (no active pulmonary disease) CXR (not the actual chest x-ray) no
older than 2 years.
d. Future TB skin tests will always test positive.
e. In this case, a student is required to complete a Tuberculosis Symptoms Screening Questionnaire annually
in lieu of a TST.
f. A CHX is good for 2 years.